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Are CrossFit enthusiasts more prone to injury?

Study suggests haste makes waste in workouts

CrossFit is a workout regime known for short, high-intensity intervals that combine strength and cardio exercises.

Photograph by: Ted Rhodes
, Calgary Herald

Since its debut in 2000, CrossFit, considered one of the hottest workouts on the market, has been dogged by questions about its safety. Known for short, high-intensity intervals that combine strength and cardio exercises, a typical Workout of the Day (WOD) lasts about 30 minutes and demands a high level of fitness and technical skill. And since there’s a timed element to most WODs, workouts can become competitive.

CrossFit advocates boast of the fitness improvements associated with workouts that include gymnastics, running, rowing, power lifting and various exercises performed with and without equipment, but there’s concern among fitness experts that CrossFit workouts lack the instruction and supervision necessary to ensure the proper execution of its large library of exercises.

Add the concern that WODs are often designed by CrossFitters with no background in exercise design and safety, and it’s no wonder that CrossFit has a reputation for increased injury among its followers.

With no available data on injury rates, there continues to be a split among fitness professionals: those who hail the fitness gains achieved from following CrossFit’s regime and those who question whether the risks outweigh the benefits.

It’s with this debate in mind that a trio of researchers from Britain polled the CrossFit community to find out how many had been injured. They posted a questionnaire on international CrossFit online forums asking age, gender and general lifestyle behaviours, including weekly workout habits. It also asked participants to list and describe any injuries sustained from CrossFit workouts.

Of the 132 responses received, 70.5 per cent were male and 29.5 per cent female with an average age of 32.3 years. The mean training history of the group included five hours of CrossFit a week, which they had maintained for the past 18.6 months.

As for injuries, 73 per cent of the respondents sustained an injury that prevented them from working out, nine of which required surgery. The most commonly injured area was the shoulder; the second most common was the spine. No one in the group reported getting a diagnosis of rhabdomyolysis, a potentially life-threatening breakdown of muscle linked to extreme exercise, and CrossFit in particular.

Claiming to be the first statistics on CrossFit injuries published in a scientific literature, the researchers estimated the risk of injury to be 3.1 injuries per 1,000 CrossFit hours trained.

“Overall rate of injuries sustained during training are broadly similar to that reported in the literature for sports including weightlifting, powerlifting and gymnastics, and lower than that reported in competitive contact sports such as Rugby League and Rugby Union,” stated the researchers in an article in the Journal of Strength and Conditioning Research titled The nature and prevalence of injury during CrossFit training.

As for how CrossFit measures up against the injury rate of more general fitness pursuits like running, triathlon and training at the gym, the numbers compiled by the researchers suggest no increased risk for CrossFit enthusiasts.

That said, the high rate of shoulder injury found among the CrossFit crowd is cause for concern.

The injury rate is higher than that attributed to elite and competitive Olympic weightlifters; CrossFit’s reliance on overhead movements combined with a propensity to lift heavy weight is the source of many of the shoulder injuries.

Stating that nine out of 15 core CrossFit workouts involve pull-ups and overhead pressing movements, the authors suggest overuse may contribute to what has become known as “CrossFit Shoulder.”

As for injuries to the spine: again, the prevalence of high-rep, high-weight and high-speed CrossFit workouts that include high-risk exercises like weighted squats, deadlifts and the clean and snatch place undue stress on the spine.

The study authors explained that “during Olympic-style weightlifting, the focus is placed on performing only one repetition of the movement; however, during CrossFit workouts, these movements are often performed with a high number of repetitions with an emphasis on speed, and this may lead to poor form and injury.”

Based on the information gathered, the researchers stated that more emphasis on proper lifting technique and less on the speed and total number of repetitions performed can reduce the rate of injury for CrossFit enthusiasts. They also suggest that a more varied workout routine will reduce injuries related to overuse.

Also worth noting: after a review of the WODs posted on CrossFit’s central website, the authors surmised that strength exercises took a back seat to other types of conditioning, which might be another reason for injury. “Without a firm strength basis, we believe performing heavy weight, high rep metabolic conditioning workouts so regularly risks injury.”

As a final footnote, the authors suggest that adequate supervision of CrossFit workouts and appropriately modified workouts based on individual fitness levels by trained coaches is also necessary to reduce injuries rates.

“The ethos of CrossFit believes in training to be prepared for the unknown and unknowable and therefore individualism is not necessary,” the researchers said. “While this may be true in certain circumstances, a degree of individualism may help define more achievable goals and reduce injury rates. We believe participation under the supervision of a dedicated CrossFit gym and coach provides this compromise.”

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